Citation Nr: 21031854 Decision Date: 05/24/21 Archive Date: 05/24/21 DOCKET NO. 17-05 848 DATE: May 24, 2021 REMANDED Service connection for left ear hearing loss. REASONS FOR REMAND The Veteran served with the Army National Guard of Alabama from December 1955 to December 1958. The case is on appeal from an August 2015 rating decision. In a December 2020 decision, the Board denied six service connection claims. At that time, the Board also remanded the left ear hearing loss claim for further development. Service connection for left ear hearing loss. In accordance with the Board's December 2020 remand, the Veteran was afforded a VA audiology examination in March 2021, which reflected a diagnosis of hearing impairment for VA purposes under 38 C.F.R. § 3.385. Despite these results and noting the Veteran's in-service noise exposure, the examiner opined that she could not determine a medical opinion regarding hearing loss without resorting to speculation because there are no audiograms located in records reviewed. Additionally, due to lack of audiometric data, no opinion can be made without speculation. Despite this and the lack of evidence demonstrating audiometric data at entrance and separation from the military, the examiner went on to provide that, assuming the Veteran had normal hearing upon leaving the military in 1958 and a claim just being made for hearing loss over 60 years after military service, the more likely cause for hearing loss would be heredity and aging. As provided in the Board's December 2020 remand, in-service noise exposure is established for the claim as his NGB Form 22 shows his military occupational specialty (MOS) during his service with the Army National Guard was AAA (possibly anti-aircraft artillery or anti-aircraft automatic weapon) gun crewman. Although the Veteran was provided with a new VA examination in March 2021, with the examiner finding hearing loss for VA purposes, the examiner failed to consider the evidence of record, including the Veteran's in-service noise exposure given his MOS. Rather, as provided above, the examiner rationalized that the Veteran's hearing loss is due to heredity and/or age. Accordingly, remand is warranted at this time such that a proper medical opinion may be obtained, and, if necessary, a VA examination, that follows the Board's remand directives. Stegall v. West, 11 Vet. App. 268 (1998). The Board also finds the March 2021 VA medical examination opinion inadequate, as it relied on a mere absence of evidence in the service and post-service treatment records to provide a negative opinion. Dalton v. Nicholson, 21 Vet. App. 23 (2007). On remand, an additional medical opinion based on full consideration of the Veteran's documented medical history and all lay assertions, and supported by a complete, clearly stated rationale is needed to resolve the claim. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (holding that when VA undertakes to provide a VA examination or to obtain a VA opinion, it must ensure that the examination or opinion is adequate). In light of the remand, updated VA treatment records should be obtained. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records, if any. 2. Thereafter, obtain from an ENT specialist an addendum opinion addressing the etiology of the Veteran's current left ear hearing loss. Only arrange for the Veteran to undergo further VA examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) by an appropriate medical professional if deemed necessary in the judgment of the individual designated to provide the addendum opinion. The ENT specialist should then provide an opinion as to whether it is at least as likely as not (i.e., at least equally probable) that the Veteran's hearing loss had its onset during, or is otherwise related to, his military service. Consideration should be given to his in-service noise exposure as an AAA (possibly anti-aircraft artillery or anti-aircraft automatic weapon) gun crewman. A complete rationale should be provided for any opinion expressed. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Becton, Associate Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.